Active NPI
Charles W Miller, DDS, MS
- Pediatric Dentistry
- Arlington, TX
National Provider Identifier
1366449761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 12597
- Practice address
- 4220 Little Road
Arlington, TX 76016 - Phone
- (817) 478-2300
- Fax
- (817) 478-4904
- NPI assigned
- Jun 30, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 12597 | TX | Primary |
Addresses
Primary practice location
4220 Little Road
Arlington, TX 76016
Mailing address
4220 Little Road
Arlington, TX 76016
Phone (817) 478-2300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 133274407 | Medicaid | TX | |
| 133274409 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12597 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643328000000",
"number": "1366449761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4220 LITTLE ROAD",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "76016",
"telephone_number": "817-478-2300",
"fax_number": "817-478-4904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4220 LITTLE ROAD",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "76016",
"telephone_number": "817-478-2300",
"fax_number": "817-478-4904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "CHARLES",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-30",
"last_updated": "2022-01-28",
"certification_date": "2022-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "12597",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "133274407",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "133274409",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arlington, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.